Histopathologic Studies on Crescentic Glomerulonephritis.
- Author:
Sungjin CHUNG
1
;
Sun Jin YOO
;
Yeo Wook YUN
;
Chang Hwa LEE
;
Kyoung Won KAHNG
;
Chong Myung KANG
;
Chan Hyun PARK
;
Moon Hyang PARK
Author Information
1. Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Crescentic glomerulonephritis;
Rapidly progressive glomerulonephritis
- MeSH:
Antibodies, Antineutrophil Cytoplasmic;
Arteries;
Atherosclerosis;
Biopsy;
Bowman Capsule;
Classification;
Creatinine;
Diagnosis;
Fibrosis;
Glomerulonephritis*;
Glomerulonephritis, IGA;
Humans;
Purpura
- From:Korean Journal of Nephrology
2003;22(3):303-312
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Crescentic glomerulonephritis is expressed pathologically by crescent formation in Bowman's capsule and clinically by rapidly progressive loss of renal function. The pathologic experience of crescentic glomerulonephritis in one institution was analyzed here. METHODS: We classified 25 cases of crescentic glomerulonephritis patients into 4 categories and reviewed the cases pathologically and clinically. RESULTS: We found no case with group I (anti- GBM disease), 8 cases in group II (immune complex glomerulonephritis) including 3 patients with IgA nephropathy, 2 patients with Henoch-Sch nlein purpura and 3 patients with APSGN, 12 cases in group III (ANCA-associated glomerulonephritis) including 7 patients with microscopic polyangitis, 4 patients with Wegener's granulmatosis and 1 patient with ANCA GN, and 5 cases in group IV (idiopathic crescentic glomerulonephritis). The mean ages of patients with group II, III, and IV were 32.0, 59.3 and 39.0 years old, respectively, and mean serum creatinine levels at the time of biopsy were measured as 9.1, 5.2, 8.8 mg/dL in each group. On light microscopic findings, the frequency of crescents in glomeruli was 64.4% in group II, 43.7% in group III, and 51.2% in group IV. The score of infiltration into tubules of inflammatory cells was 0.8 in group II, 0.4 in group III, and 0.6 in group IV and the score of fibrosis in interstitium was 1.0 in group II, 0.8 in group III and 1.2 in group IV. The score of atherosclerosis in arteries was 1.4, 0.9 and 1.6 in each group. CONCLUSION: We conclude that the precise diagnosis and classification of crescentic glomerulonephritis by an early renal biopsy and clinical assessments are important in the management of rapidly progressive (crescentic) glomerulonephritis. Since the number of the cases was not so enough, we could not analyze the statistical significance between morphologic differences of each group of crescentic glomerulonephritis, but if more cases were collected, acknowledgements of differences and prognostic factors in pathologic findings could be possible.
